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Rare head and neck cancer linked to HPV, study finds

added 10/7/09

Ann Arbor - An increase in cases of a rare type of head and neck cancer appears to be linked to
HPV, or human
papillomavirus, according to a new study from researchers at the University of Michigan Comprehensive Cancer Center.

Thomas Carey, PhD., Kitrina Cordell and Bhavna Kumar

The study looked at patients with nasopharyngeal cancer, a tumor that grows behind the nose and at the top of the throat,
above the tonsils. This rare cancer occurs in less than 1 of every 100,000 Americans.

"Though rare, this is the first report of nasopharyngeal cancer being caused by the HPV epidemic. We are in the middle of a
tonsil cancer epidemic, seeing many patients with tonsil cancer linked to HPV. It turns out that HPV may also be a new cause of
this rare form of cancer that occurs in this hidden location," says study author Carol Bradford, M.D., professor and chair of
otolaryngology at the U-M Medical School.

In the study, which appears online in the journal Head & Neck, the researchers looked at tissue samples taken before
treatment for either nasopharyngeal cancer or tonsil cancer. Of the 89 patients in the study, five had nasopharyngeal cancer,
and four of those were positive for HPV.

At the same time, the four HPV-positive tumors were also all negative for Epstein-Barr virus, which has previously been one
of the biggest infectious causes of nasopharyngeal cancer.

"Since I began studying head and neck cancer, I have wondered what the cause of Epstein-Barr virus-negative nasopharyngeal
tumors might be. This research suggests that there is a changing etiology for nasopharyngeal cancer in the North American
population that may mirror the HPV-positive epidemic of tonsil cancer," says study author Thomas Carey, Ph.D., professor of
otolaryngology and pharmacology and co-director of the head and neck
oncology program at the U-M Comprehensive Cancer Center.

Overall, about 60 percent of nasopharyngeal cancer patients are alive five years after treatment. In fact, death rates for this
type of cancer have declined 4 percent per year. The researchers suspect one potential reason is that HPV-related tumors are more
responsive to chemotherapy or radiation than tumors linked to the Epstein-Barr virus.

Because nasopharyngeal cancer is so rare, the authors propose a multi-center trial to recruit more patients to verify the role
of HPV in nasopharyngeal cancer.